Provider Demographics
NPI:1497131361
Name:TRAN, ANDREW (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COBB PKWY
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-8566
Mailing Address - Country:US
Mailing Address - Phone:706-891-2590
Mailing Address - Fax:706-891-2589
Practice Address - Street 1:100 COBB PKWY
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-8566
Practice Address - Country:US
Practice Address - Phone:706-891-2590
Practice Address - Fax:706-891-2589
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD0000003248152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist